| NPI | 1023190188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME45416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD206528) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2021-08-06 |